Percutaneous Kirschner-wire pinning for severely displaced distal radial fractures in children. A report of 157 cases
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TL;DR: Percutaneous Kirschner-wire pinning on 157 high-risk distal radial fractures in children under 16 years of age reduced the predicted early and late failure rate and the predicted significant limitation of forearm movement in the final assessment at a mean of 31 months after operation.
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Abstract: Distal radial fractures are common in children. Recent outcome studies have cast doubt on the success of treatment by closed reduction and application of plaster. The most important risk factor for poor outcome is translation of the fracture. If a distal radial fracture is displaced by more than half the diameter of the bone at the fracture site it should be classified as high risk. We performed percutaneous Kirschner-wire pinning on 157 such high-risk distal radial fractures in children under 16 years of age. The predicted early and late failure rate was reduced from 60% to 14% and only 1.5% of patients had significant limitation of forearm movement of more than 15 degrees in the final assessment at a mean of 31 months after operation. There were no cases of early physeal closure or deep infection.
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Citations
Dorsal distal radius fractures in children: role of plaster in redisplacement of these fractures.
TL;DR: Poor modeling immobilization of the wrist in the cast, studied by the three-point index was the only significant risk factors for redisplacement.
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Selective Kirschner wiring for displaced distal radial fractures in children
TL;DR: There should be other factors involved in the development of redisplacement and the need for remanipulation other than the degree of fracture displacement and the quality of initial reduction, the data suggest.
27
Intrafocal pinning of distal radius fractures: a simplified approach.
TL;DR: The use of intrafocal pinning is described as a simple and effective approach in the treatment of extra-articular distal radius fractures (Colles’ fractures) and it produces results that are superior to closed reduction alone.
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The value of the three-point index in predicting redisplacement of diaphyseal fractures of the forearm in children
TL;DR: The three-point index (TPI) was far superior to other radiological indices, with a sensitivity of 84% and a specificity of 97% in successfully predicting redisplacement, and is recommended for routine use in the management of these fractures in children.
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Die elastisch stabile intramedulläre Nagelung bei instabilen kindlichen Unterarmschaftfrakturen.
Jürgen Wasem,Pamela Aidelsburger,Kristin Grabein,A. Huber,H. Hertlein +4 more
- 01 Jan 2006
TL;DR: Diese drei Behandlungsstrategien bei instabilen Unterarmschaftfrakturen soll fur diesen Health Technology Assessment (HTA)-Bericht eine systematische Darstellung der Effektivitat im Hinblick auf die internationale Datenlage durchgefuhrt werden.
References
Percutaneous Kirschner-wire fixation of Colles fractures. A prospective study of thirty cases.
TL;DR: The study showed that additional fixation improves both the anatomical and the functional results after a Colles fracture and should be used if the articular surface of the radius is not comminuted into more than two fragments.
197
Redisplacement after closed reduction of forearm fractures in children.
TL;DR: It is concluded that 7% of pediatric forearm fractures treated by closed reduction are subject to reangulation and/or displacement following routine acceptable primary treatment, and that remanipulation provides a safe, effective means to obtain and maintain reduction.
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Forearm fractures in children: pitfalls and complications.
David R. Davis,Donald P. Green +1 more
TL;DR: The most important apparent conclusion reached from this study is that greenstick and complete fractures are different, and that some of the pitfalls and complications seen following these injuries can be avoided if different methods of reduction are used for each.
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Translation of the radius as a predictor of outcome in distal radial fractures of children
TL;DR: A retrospective analysis of 94 children with fractures of the distal third of the radius, with or without ulnar fractures, treated by primary closed reduction and plaster found Translation of the Radius was the single most reliable predictor of outcome.
97
Angulation of the radius in children's fractures
TL;DR: Age at the time of injury, the site of the fracture and the degree and direction of angulation at union were correlated with loss of forearm rotation at review 3.5 to 6 years later.
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